Is it true that the mercury in dental fillings could be harmful to my child's health?

There's no evidence that it is. An extensive review published in 1993 by the U.S. Department of Health and Human Services concluded that amalgam fillings containing mercury pose no health risk, except in the extremely rare case that a patient is allergic to them. And while some people continue to worry that these fillings may be harmful to their developing or unborn children, no reliable studies since then have contradicted the government's conclusion.

The substance most commonly used in dental fillings is an amalgam (or mixture) of silver, mercury, tin, and copper. This substance has been used to fill cavities for more than 150 years. It is widely considered by dentists to be the best material available for this purpose because it has proven to be safe, more effective than plastic (the tooth-colored option now available), and more economical than gold or porcelain. Over the last ten or 15 years, opponents of amalgam fillings have linked them to various diseases such as chronic fatigue syndrome, multiple sclerosis, asthma, and Alzheimer's. But none of the peer-reviewed research has supported these fears. In fact, the National Multiple Sclerosis Society has even issued a statement in support of amalgam fillings.

People who have amalgam fillings (which are also called silver fillings) may be exposed to miniscule amounts of mercury vapor when they chew food or grind their teeth. While they exhale much of this vapor, they may swallow some of it. But studies show that people ingest far more mercury from eating fish, and even from drinking water and breathing the air, than they do from their fillings. In fact, some tests have found that, on average, people who have amalgam fillings have no higher levels of mercury in their urine (which is where most metallic mercury winds up) than people who do not.

To be absolutely sure that this exposure poses no danger, researchers continue to study the issue. A recent public health statement by the Department of Health and Human Services explains that while "U.S. government summaries conclude that there is no apparent health hazard from dental amalgam to the general population, further study is needed to determine the possibility of more subtle behavioral or immune system effects in sensitive populations," including pregnant women and children under the age of 6. Two studies on the long-term health effects of fillings in children are scheduled to reach their conclusions in 2003.

In the meantime, if you're concerned or fearful about this, what are your alternatives? First, speak with your dentist about your fears. If you are still concerned, you may opt for plastic (also called composite resin) instead of amalgam. The main disadvantage of this option is that it does not form as good a seal with the surface of the tooth and may allow bacteria to penetrate under the filling where they can cause another cavity to develop. It will also not last as long as amalgam. In any case, do not try to have amalgam fillings taken out since there is currently no evidence that they are harmful and, in any case, the removal process may expose you or your child to more mercury than you would ingest as a result of keeping them in.

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